Critical care nursing quarterly
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Most healthcare practitioners have worked with patients with spinal cord injury at some point in their career, for some it is a specialty. The critical care area usually only has patient with spinal cord injury for a brief time before they are transferred. ⋯ As part of the multispecialty team, nurses can be pivotal in preventing secondary complications, especially pressure ulcers. Rehabilitation team members can be consulted early to provide expertise in managing this complex diagnostic group.
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Pain is a frequent experience throughout our lifetime, and each person responds in a different manner to every pain experience. Critically ill trauma patients are obviously more likely to experience pain due to their injuries or iatrogenic causes. ⋯ Understanding the pathophysiology of pain facilitates the assessment of the objective components of pain. It is imperative for the critical care nurse to function as the patient advocate especially regarding pain management issues.
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Traumatic brain injury is a leading cause of death by trauma in adults in the United States and a major contributor to permanent physical, emotional, and psychological disabilities. Therapeutic hypothermia, defined as cooling of the body to less than 36 degrees C, has been shown to decrease mortality and morbidity and improve long-term outcomes by protecting the brain from secondary brain injury. The most commonly seen benefits of hypothermic temperatures of 32 degrees C to 33 degrees C are a significant reduction in intracranial hypertension and improved cerebral perfusion and oxygenation. ⋯ The following article will define hypothermia and provide critical information necessary to provide care for the critically ill patient under therapeutic hypothermia. It will define the processes of brain injury and how hypothermia is thought to counteract those to protect the brain. Also included is a review of 2 major randomized, controlled trials of hypothermia for traumatic brain injury that have been instrumental in establishing guidelines and directing further research.
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Review Case Reports
Meningococcal meningitis in critical care: an overview, new treatments/preventions, and a case study.
Meningococcal meningitis (MM) is a disease process that can become insidious and deadly in a short amount of time if not properly diagnosed. New and effectively known treatments and preventions are the key to improve recovery. The Neisseria meningitidis (NM) bacteria is the culprit in the MM discussed in this article. ⋯ Chemoprophylaxis efficacy may also be of help to those healthcare workers exposed as well as to those individuals at high risk for contracting the disease after an exposure. Public health concerns with community and college campus participation and education can be key to a sense of well-being among those possible individuals who may be exposed. Steroid, coagulapathy, and immunotherapy, as well as other new treatments, are worth investigating and pursuing in these times of increased risk to certain vulnerable populations of people.
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Spinal injuries are devastating, often leaving the patient paralyzed or with a permanent deficit. Aspiring athletes may not be able to persue their dreams secondary to a spinal injury; families are often left without a major wage earner to support them; and individuals are dependent upon others for the fulfillment of their basic needs. Education is essential for the prevention of primary and secondary spinal injuries; nurses play a key role in both these areas.